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Accident Expense and Symptom Log
By Serdar Arslan, editor · Last reviewed · How we research
Six months after a crash, few people can say how many therapy visits they had or what they spent driving to the pharmacy. Insurance claims often turn on exactly those details, along with missed work hours and how the injury changed your days. This log gives you one place to record all of it as you go.
Fill in the expense section whenever you pay for something related to the accident, and keep the receipts in the same folder. Use the symptom section once a day or a few times a week, writing short, honest entries. Record missed work and every call or email with an insurer.
A dated log gives you, and any adjuster or attorney involved, a clear picture of your losses. Write only facts and your own experience, and avoid exaggerating, since logs may be shared with insurers or used in a lawsuit.
ACCIDENT EXPENSE AND SYMPTOM LOG ================================================== Name: [Your full name] Accident date: [Date of the accident] Log started: [Log start date] Claim numbers: [Claim numbers (all insurers)] Adjusters: [Adjuster names and contact details] Medical providers: [Medical providers seen] Employer / supervisor: [Employer and supervisor contact (for lost time)] PART A – EXPENSES (medical bills, prescriptions, co-pays, mileage to appointments, towing, rental, parking, medical equipment, help at home) Date | Description | Paid to | Amount | Rcpt? | Paid by ------------+--------------------------------+----------------------+-----------+-------+--------- ___/___/___ | ______________________________ | ____________________ | $________ | ____ | ________ ___/___/___ | ______________________________ | ____________________ | $________ | ____ | ________ ___/___/___ | ______________________________ | ____________________ | $________ | ____ | ________ ___/___/___ | ______________________________ | ____________________ | $________ | ____ | ________ ___/___/___ | ______________________________ | ____________________ | $________ | ____ | ________ ___/___/___ | ______________________________ | ____________________ | $________ | ____ | ________ ___/___/___ | ______________________________ | ____________________ | $________ | ____ | ________ ___/___/___ | ______________________________ | ____________________ | $________ | ____ | ________ PART B – DAILY SYMPTOMS AND LIMITS (rate pain 0–10; note where it hurts, sleep, activities you could not do, mood) Date | Pain | Symptoms / location | Activities missed or limited | Meds taken ------------+---------+------------------------------------+------------------------------------+------------- ___/___/___ | ____ / 10 | __________________________________ | __________________________________ | ____________ ___/___/___ | ____ / 10 | __________________________________ | __________________________________ | ____________ ___/___/___ | ____ / 10 | __________________________________ | __________________________________ | ____________ ___/___/___ | ____ / 10 | __________________________________ | __________________________________ | ____________ ___/___/___ | ____ / 10 | __________________________________ | __________________________________ | ____________ ___/___/___ | ____ / 10 | __________________________________ | __________________________________ | ____________ ___/___/___ | ____ / 10 | __________________________________ | __________________________________ | ____________ ___/___/___ | ____ / 10 | __________________________________ | __________________________________ | ____________ PART C – TIME MISSED FROM WORK Date | Hours | Reason (injury, appointment, therapy) | Pay lost ------------+--------+------------------------------------+---------- ___/___/___ | ______ | ______________________________ | $________ ___/___/___ | ______ | ______________________________ | $________ ___/___/___ | ______ | ______________________________ | $________ ___/___/___ | ______ | ______________________________ | $________ ___/___/___ | ______ | ______________________________ | $________ PART D – CONTACT LOG (insurers, providers, police, others) Date | Who | Method | Summary of what was said or agreed ------------+----------------------+--------+------------------------------------------ ___/___/___ | ____________________ | ______ | ________________________________________ ___/___/___ | ____________________ | ______ | ________________________________________ ___/___/___ | ____________________ | ______ | ________________________________________ ___/___/___ | ____________________ | ______ | ________________________________________ ___/___/___ | ____________________ | ______ | ________________________________________ -------------------------------------------------- Totals this page: Expenses $__________ Hours missed ______ Pay lost $__________
Tips
- Write entries on the same day when possible; dated, consistent notes are more useful than ones reconstructed later.
- Track mileage to medical appointments, pharmacies, and repair shops; some claims include travel costs.
- Note good days as well as bad ones. An honest record is more believable.
- Keep receipts, explanation-of-benefits statements, and pay stubs together with this log.
- Remember that what you write may be shared with insurers or the other side in a lawsuit.
Sending it and keeping proof
Keep a copy of everything you send. If a deadline or a response time matters, send letters by a method that gives you proof of delivery, such as certified mail with a return receipt, or email with a read receipt, and note the date in your claim file. Many insurers and agencies also accept uploads through an online portal, so save the confirmation screen or email.